Honorary Fellow of the Royal College of Obs. & Gyn. First Indian to receive FIGO s Distinguished Merit Award for Services towards women s health.

Size: px
Start display at page:

Download "Honorary Fellow of the Royal College of Obs. & Gyn. First Indian to receive FIGO s Distinguished Merit Award for Services towards women s health."

Transcription

1 Prof.Duru Shah Founder President The PCOS Society (India) President Elect of the Indian Society for Assisted Reproduction (ISAR) Honorary Fellow of the Royal College of Obs. & Gyn. First Indian to receive FIGO s Distinguished Merit Award for Services towards women s health. Director Gynaecworld.. The Center for Womens Health & Fertility Prof.and : Breach Candy Hosp. Cons. Obs. Jaslok Hospital & Gyn Global Hospital

2 Assisted Reproduction for PCOS-are the results different? Prof. MD FRCOG FCPS FICS FICOG FICMCH DGO DFP PCOS Understanding the Science and Practice 19 th June, 2016 Mumbai

3 Background PCOS patients comprise 75% of ovulatory infertility. Studies have suggested that PCOS women may have less favorable outcomes with ARTconflicting evidence PCOS patients have oocytes, but of impaired quality fertilization, cleavage, implantation rates and miscarriage rates. Re. Standmauer L. et.al.(2005) Treat Endocrinol 4: Heijnen EM et. al. (2006) Hum Reprod. Update 12: Sahu K., et. al.(2008) Arch Gynecol Obstet 277:

4 Areas to be discussed Does PCOM affect the quality of eggs and embryos? Does obesity due to PCOS affect results in ART? Is the outcome of ART in PCOS women different from non-pcos women?. Is the Fertile window extended in women with PCOS? Is In Vitro Maturation (IVM) a better solution?

5 Does PCOM affect the quality of eggs and embryos? Prospective comparative study of 194 PCOS pts. with age matched controls treated concurrently. COH + ICSI All 194 women had exclusive male infertility 97 had PCOM and 97 were normal (control group) 1013 oocytes from PCOM patients compared with 774 oocytes from controls. Ref. Sigale et.al. Fertil Steril Jan 2015

6 Results Mean number of total + M II oocytes sig. in PCOM group. Rate of M II morphologically abnormal oocytes equivalent between both groups. Mean no. of embryos significantly in PCOM group. Percentage of top quality embryos on Day 3 similar between both the groups. Ref. Sigale et.al. Fertil Steril Jan 2015

7 Results Implantation and clinical pregnancy rates were significantly in PCOM group. Conclusions PCOM does not have a negative impact on the quality of oocytes and embryos or the outcome of IVF / ICSI. Ref. Sigale et.al. Fertil Steril Jan 2015

8 Does Obesity affect ART results in PCOS? Retrospective Cohort Study 101 cycles in 79 PCOS women < 40 yrs. Lean (51) kg/m 2 Overweight (19) kg/m 2 Obese (31) - > 30 kg/ m 2 Aim was to study the effect of BMI on ART outcomes in a PCOS population. Ref. Amelia P. Bailey et.al. Am J. Obstet Gynecol 2014: 211: 163

9 Conclusions:- PCOS has 2 distinct populations lean and obese Both have different IVF outcomes Obese PCOS have a 75% chance of pregnancy rate per ET, compared with lean PCOS The odds of live birth were 77% lower per ET in obese v/s lean PCOS There is a chance of OHSS in BMI in women with PCOS % in lean PCOS % overweight % obese Ref. Amelia P. Bailey et.al. Am J.Obstet Gynecol 2014:211:163

10 Outcome of ART in PCOS v/s Non PCOS women Prospective Study Group I women with PCOS with 122 Group II - 91 women with tubal factor infertility Re. Salem WH et.al. Androl Gynecol: Curr Res 2014,2:3

11 Outcome of ART in women with PCOS v/s Tubal Factor Ovarian stimulation characteristics PCOS (n=122) Re. Salem WH et.al. Androl Gynecol: Curr Res 2014,2:3 Tubal Factor (n=91) P-Value Agonist 0% 70.3% <0.001 Antagonist 100% 29.7% <0.001 Total duration of treatment (days) 9.5 ± ± 2.1 NS Total dose of rfsh or Gonadotropin (IU) 1910 ± ± 1040 <0.001 Serum E 2 on day of HCG(ng/mL) 2370 ± ± 1247 NS Serum P 4 on day of HCG(ng/mL 1.1 ± ± 0.4 <0.01 # Follicles 14 on day of HCG 15.6 ± ± 5.6 <0.001 # Follicles 16 on day of HCG 9.4 ± ± 3.8 <0.01 Endometrial thickness (mm) on day of HCG 10.6 ± ± 2.0 <0.01

12 Outcome of ART in women with PCOS v/s Tubal Factor Embryology Data PCOS (n=122) Tubal Factor (n=91) P-Value # Mature oocytes <0.001 # 2 PN <0.001 Fertilization rate 76.0% 79.6% <0.05 #Frozen zygote <0.01 # Day 3 embryos <0.001 # Day 5 blastocysts <0.001 # Day 6 blastocysts NS # Day 5 Frozen blastocyst NS # Day 6 frozen blastocysts NS # Total frozen blastocysts NS Re. Salem WH et.al. Androl Gynecol: Curr Res 2014,2:3

13 Outcome of ART in women with PCOS v/s Tubal Factor Embryology Data PCOS (n=122) Tubal Factor (n=91) P-Value # Embryos transferred (Day 3) NS Morula transferred (Day 5) NS Blastocysts transferred (Day 5) <0.001 Excellent blastocysts <0.05 Good blastocysts NS Early blastocysts NS # total transferred Day 5 (morula and blastocyst) NS % of Day 3 transfer 22.1% 41.8% <0.01 Re. Salem WH et.al. Androl Gynecol: Curr Res 2014,2:3

14 Outcome of ART in women with PCOS v/s Tubal Factor Pregnancy outcome PCOS (n=122) Tubal Factor (n=91) P-Value Implantation rate 40.9% 34.6% NS Clinical pregnancy(%) 76(62.3%) 49(53.8%) NS Delivered (%) 69(56.6%) 45(49.5%) NS Biochemical pregnancy (%) 9(10.6%) 2(3.9%) NS Miscarriage(%) 7(9.2%) 4(8.1%) NS Multiple pregnancy (%) 34(44.7%) 23(46.9%) NS Re. Salem WH et.al. Androl Gynecol: Curr Res 2014,2:3

15 Embryology Data Gynaecworld Data PCOS (n=189) Non-PCOS (n=133) P-Value Total number of follicles < Mean number of follicles Total number of oocytes <0.001 Mean number of oocytes NS Total number of mature oocytes < Mean number of mature oocytes Recovery rate of mature oocytes(%) 70.04% 84.14% Total number of immature oocytes <0.001 Mean number of immature oocytes Fertilization rates 74.00% (1500/2027) Cleavage rates 70.93% (1064/1500) Re. Gynaecworld unpublished data % (923/1157) 76.02% (704/926) < (NS)

16 Pregnancy outcome Gynaecworld Data PCOS Non-PCOS P-Value OHSS 12.69% 8.27% (11/133) < 0.02 Significant Pregnancy rate 38.09% (72/189) Live birth rate 73.61% (53/72) Abortion rate 5.55% (4/72) Biochemical preg. Rate 8.33% (6/72) Ectopic preg.rate 2.77% (2/72) Re. Gynaecworld unpublished data % (54/133) 72.22% (39/54) 7.40% (4/54) 5.55% (3/54) 3.70% (2/54) < 0.65 NS < 0.86 NS < 0.67 NS < NS < 0.72 NS

17 ART in PCOS- Multicentric Indian Trial Study: Prospective Observational study on PCOS carried out in 7 centers in India between Aug July women undergoing IVF / ICSI included 77 - PCOS 115 Non PCOS All patients had Long protocols and Rec. FSH Ref. Pratap Kumar et.al. J Hum Reprod Sci Jan- Mar.6(1) 49-53

18 ART in PCOS- Multicentric Indian Trial Results: PCOS Group Non PCOS Group Follicles 27.2 ± ± 5.3 Oocytes 15.9 ± ± 6.2 Recovery rate of oocytes 64% 80.3% Mature oocytes 61.1% 74.5% Total no. of top quality embryos Pregnancy Rates comp. to Non PCOS groups Comparable in both groups. Ref. Pratap Kumar et.al. J Hum Reprod Sci Jan- Mar.6(1) 49-53

19 Is the Fertile window extended in women with PCOS? Known Facts PCOS women have density of small Antral follicles. Ovarian cortical biopsies show a 6 times density of primordial and primary follicles in women with PCOS v/s women with regular periods. Surrogate markers of ovarian reserve such as AMH and AFC are also increased in PCOS. Ref. Webber LJ. et.al. Lancet 2003; 362:

20 This could suggest that either PCOS women are born with an increased no. of germ cells at birth or there is a rate of loss of germ cells. Does this mean that women with PCOS have a higher chance to be pregnant v/s non PCOS women as they age? How should we counsel our patients? Ref. Webber LJ. et.al. Lancet 2003; 362:

21 Is the Fertile window extended in women with PCOS? Most of the patients get pregnant with oral ovulation inducing agents, but some require ART due to co-existing causes of infertility or to prevent multiple pregnancy due to COH Ref. Hudeova M et.al. Hum. Reprod. 2009: 24: Koivunen R. et.al. Hum. Reprod. 2008: 23:2134-9

22 Is the fertile window extended in women with PCOS? Retrospective Cohort study 42, 286 IVF cycles in women with PCOS and tubal factor infertility. Utilizing the SART Registry Out come Pregnancy and live birth rates. Ref. Kalra SK, Dokra A,. et.al. Fertility & Sterility vol. 100, July 2013:

23 Is the fertile window extended in women with PCOS? PCOS Tubal Factor P-Value Total IVF cycles 16, NS No. of oocytes retrieved No. of cryopreserved embryos, mean ± SD 6 ± ± 4.3 <.001 Subjects with cryopreserved embryos,% <.001 Implantation rate,% <.001 Clinical preg. rate/ cycle start,% <.001 Miscarriage rate, % <.001 Live-birth rate/ cycle start,% <.001 Pregnancy plurality, % Singleton Twin Higher order multiple preg.( triplet) Re. Kalra SK, Dokra A, et.al Fertility & Sterility vol :

24 Is the fertile window extended in women with PCOS? Conclusions In spite of an increased number of oocytes obtained in PCOS patients in all age groups, women above 40 years had the same clinical preg. rates and live birth rates as non PCOS women and there was no reproductive advantage. Ref. Kalra SK, Dokra A,. et.al. Fertility & Sterility vol. 100, July 2013:

25 Is the fertile window extended in women with PCOS? Conclusions These findings suggest that the reproductive window may not be extended in PCOS. Hence women with PCOS should also be treated in a timely manner in spite of high ovarian reserve indicators. Ref. Kalra SK, Dokra A,. et.al. Fertility & Sterility vol. 100, July 2013:

26 Invitro Maturation (IVM) In PCOS patients, COH may lead to:- Large cohort of foll. of uneven sizes and quality. Retrieval of Immature oocytes risk of OHSS To avoid above, earlier retrieval of immature oocytes followed by IVM + IVF / ICSI is suggested. But does IVM give comparable outcomes? Ref. Cochrane Database Syst. Rev. Oct. 2013

27 Aim: To compare the outcomes assosc. with IVM foll. by IVF/ ICSI v/s Conventional IVF / ICSI All RCT s reviewed for assessing eligibility and quality of trials. No RCT s were suitable for inclusion in the Review, 3 ongoing trials currently but. Conclusions:- Invitro Maturation (IVM) Promising data on IVM techniques have been published, yet no evidence from RCTS available in order to base any practice recommendations. Ref. Cochrane Database Syst. Rev. Oct. 2013

28 Are the children born after IVM Study normal? Obst. and Perinatal Data collected from all deliveries after IVM treatment Growth and development of IVM children were assessed at 6,12,24 months. 43 women del. 40 singleton infants 3 sets of Twins Ref. Soderstrom et. Al. Hum Reprod. June 2006

29 Obstetric & Perinatal Outcome after IVM Obst. Complications- 15 pregnancies (35%) Mean B.Wt. of singletons = 3550 ± 441 gms. Twins = 2622 ± 194 gms. Preterm Birth No perinatal deaths: at 12 months- 8 children (19%) minor devel. problems. 1 child optical glioma at 24 months- Neuro psychological development normal range Ref. Soderstrom et. Al. Hum Reprod. June 2006

30 Conclusions PCOM does not have a negative impact on the quality of oocytes and embryos or the outcome of IVF / ICSI Obesity with PCOS chance of pregnancy, live birth, OHSS. Pregnancy outcome is comparable in PCOS and non PCOS women. PCOS women above 40 do not have reprod. advantage over non PCOS women No evidence from RCTs to confirm if In vitro Maturation gives birth result.

President : Indian Society for Assisted Reproduction (ISAR) Past President FOGSI. Past Chairman ICOG. Founder Trustee Women s Empowerment Foundation

President : Indian Society for Assisted Reproduction (ISAR) Past President FOGSI. Past Chairman ICOG. Founder Trustee Women s Empowerment Foundation Founder President: The PCOS Society, India Honorary Fellow of the Royal College of Obst.& Gyn. Prof.Duru Shah President : Indian Society for Assisted Reproduction (ISAR) Past President FOGSI. Past Chairman

More information

Influence ovarian stimulation on oocyte and embryo quality. Prof.Dr. Bart CJM Fauser

Influence ovarian stimulation on oocyte and embryo quality. Prof.Dr. Bart CJM Fauser Influence ovarian stimulation on oocyte and embryo quality Prof.Dr. Bart CJM Fauser How to balance too much vs too little? Lecture Outline Context ovarian stimulation Impact ovarian stimulation on oocyte

More information

A Tale of Three Hormones: hcg, Progesterone and AMH

A Tale of Three Hormones: hcg, Progesterone and AMH A Tale of Three Hormones: hcg, Progesterone and AMH Download the Ferring AR ipad/iphone app from the Apple Store: http://bit.ly/1okk74m Interpreting Follicular Phase Progesterone Ernesto Bosch IVI Valencia,

More information

Number of oocytes and live births in IVF

Number of oocytes and live births in IVF Number of oocytes and live births in IVF Dr Sesh K Sunkara MD, MRCOG Royal Marsden Hospital, London Kings Healthcare Partners (Guy s & St Thomas NHS Foundation Trust), London, UK Background IVF results

More information

IVM in PCOS patients. Introduction (1) Introduction (2) Michael Grynberg René Frydman

IVM in PCOS patients. Introduction (1) Introduction (2) Michael Grynberg René Frydman IVM in PCOS patients Michael Grynberg René Frydman Department of Obstetrics and Gynecology A. Beclere Hospital, Clamart, France Maribor, Slovenia, 27-28 February 2009 Introduction (1) IVM could be a major

More information

Thrombosis during assisted reproduction. Scott Nelson Muirhead Chair in Obstetrics & Gynaecology

Thrombosis during assisted reproduction. Scott Nelson Muirhead Chair in Obstetrics & Gynaecology Thrombosis during assisted reproduction Scott Nelson Muirhead Chair in Obstetrics & Gynaecology ART can be as safe as natural pregnancy!! What used to be the risk of thrombosis in ART!! We can use AMH

More information

Minimising IVF related mortality and morbidity. Scott Nelson Muirhead Professor in Obstetrics & Gynaecology

Minimising IVF related mortality and morbidity. Scott Nelson Muirhead Professor in Obstetrics & Gynaecology Minimising IVF related mortality and morbidity Scott Nelson Muirhead Professor in Obstetrics & Gynaecology We rarely say no - so what I will cover today VTE as an example of a modifiable IVF complication

More information

Universal Embryo Cryopreservation: Frozen versus Fresh Transfer. Zaher Merhi, M.D.

Universal Embryo Cryopreservation: Frozen versus Fresh Transfer. Zaher Merhi, M.D. Universal Embryo Cryopreservation: Frozen versus Fresh Transfer Zaher Merhi, M.D. Disclosure: None Fewer complications with IVF 1.5% children in US are born through ART 1.1 million children since 2006

More information

Are all-freeze cycles & frozen-thawed embryo transfers improving IVF outcomes?

Are all-freeze cycles & frozen-thawed embryo transfers improving IVF outcomes? Are all-freeze cycles & frozen-thawed embryo transfers improving IVF outcomes? Andrea Weghofer Foundation for Reproductive Medicine 2017 New York, November 16-19 Conflict of interest No relevant financial

More information

STIMULATION AND OVULATION TRIGGERING

STIMULATION AND OVULATION TRIGGERING STIMULATION AND OVULATION TRIGGERING Professor IOANNIS E. MESSINIS MD, PhD (Aberdeen, UK), FRCOG (UK) Department of Obs/Gynae University of Thessaly Larissa, GREECE DISCLOSURE Nothing to disclose Learning

More information

IVF AND PREIMPLANTATION GENETIC TESTING FOR ANEUPLOIDY (PGT-A) WHAT THE COMMUNITY PHYSICIAN NEEDS TO KNOW

IVF AND PREIMPLANTATION GENETIC TESTING FOR ANEUPLOIDY (PGT-A) WHAT THE COMMUNITY PHYSICIAN NEEDS TO KNOW IVF AND PREIMPLANTATION GENETIC TESTING FOR ANEUPLOIDY (PGT-A) WHAT THE COMMUNITY PHYSICIAN NEEDS TO KNOW Jon Havelock, MD, FRCSC, FACOG Co-Director - PCRM Disclosure No conflict of interest in relation

More information

Does PCOS Compromise the oocyte and embryo quality or the endometrium?

Does PCOS Compromise the oocyte and embryo quality or the endometrium? Does PCOS Compromise the oocyte and embryo quality or the endometrium? Richard S. Legro, M.D., Penn State College of Medicine, Dept of Ob/Gyn, Hershey, PA, USA Disclosures Consultant: Bayer, Ogeda (Euroscreen),

More information

% Oocyte Donation Pregnancyes (days 3)

% Oocyte Donation Pregnancyes (days 3) Ovulation induction in oocyte donors Roma- September 2007 Dr. José Remohí Dr. Carmen Rubio Dr. Amparo Mercader Dr. Pilar Alama Dr. Marco Melo Evolution of oocyte donation cycles 1500 1500 1000 58% 661

More information

Poor & Hyper responders: what is the best approach?

Poor & Hyper responders: what is the best approach? Poor & Hyper responders: what is the best approach? A. La Marca ObGyn Dept University of Modena and Reggio Emilia Italy Center for Reproductive Medicine University Hospital of Modena Italy Criteria used

More information

Chen et al. Reproductive Biology and Endocrinology (2018) 16:36 https://doi.org/ /s z

Chen et al. Reproductive Biology and Endocrinology (2018) 16:36 https://doi.org/ /s z Chen et al. Reproductive Biology and Endocrinology (2018) 16:36 https://doi.org/10.1186/s12958-018-0352-z RESEARCH Open Access Pregnancy outcomes of PCOS overweight/ obese patients after controlled ovarian

More information

Progesterone and clinical outcomes

Progesterone and clinical outcomes Synchronization of Slowly Developing Embryos Restores Implantation Success Richard T. Scott, Jr, MD, HCLD Clinical and Scientific Director, Reproductive Medicine Associates of New Jersey Professor and

More information

Sample size a Main finding b Main limitations

Sample size a Main finding b Main limitations 1 Table 1. Available studies on the relation between endometriosis and miscarriage (1995-2015). Study (citation) Country Study period Study design Sample size a Main finding b Main limitations Matoras

More information

Interpreting follicular Progesterone: Late follicular Progesterone to Estradiol ratio is not influenced by protocols or gonadotropins used

Interpreting follicular Progesterone: Late follicular Progesterone to Estradiol ratio is not influenced by protocols or gonadotropins used Interpreting follicular Progesterone: Late follicular Progesterone to Estradiol ratio is not influenced by protocols or gonadotropins used Ellenbogen A., M.D., Shalom-Paz E., M.D, Asalih N., M.D, Samara

More information

Trends in Egg Donation. Vitaly A. Kushnir MD Center for Human Reproduction

Trends in Egg Donation. Vitaly A. Kushnir MD Center for Human Reproduction Trends in Egg Donation Vitaly A. Kushnir MD Center for Human Reproduction Disclosures No relevant financial relationships to disclose CHR views the commercial trade in human oocytes with considerable ethical

More information

Best practices of ASRM and ESHRE

Best practices of ASRM and ESHRE Best practices of ASRM and ESHRE Late submission Cortina d Ampezzo, Italy 1-3 March 2012 A joint meeting between the American Society for Reproductive Medicine and the European Society of Human Reproduction

More information

Milder is better? Advantages and disadvantages of "mild" ovarian stimulation for human in vitro fertilization

Milder is better? Advantages and disadvantages of mild ovarian stimulation for human in vitro fertilization Milder is better? Advantages and disadvantages of "mild" ovarian stimulation for human in vitro fertilization Revelli et al. Reproductive Biology and Endocrinology 2011, 9:25 Presenter: R2 孫怡虹 Background

More information

Recent Developments in Infertility Treatment

Recent Developments in Infertility Treatment Recent Developments in Infertility Treatment John T. Queenan Jr., MD Professor, Dept. Of Ob/Gyn University of Rochester Medical Center Rochester, NY Disclosures I don t have financial interest or other

More information

(BMI)=18.0~24.9 kg/m 2 ;

(BMI)=18.0~24.9 kg/m 2 ; 33 10 Vol.33 No.10 2013 10 Oct. 2013 Reproduction & Contraception doi: 10.7669/j.issn.0253-357X.2013.10.0672 E-mail: randc_journal@163.com - ( 400013) : () GnRH-a - () : IVF- ET 233 A (I~II 102 ) B (III~IV

More information

Fertility 101. About SCRC. A Primary Care Approach to Diagnosing and Treating Infertility. Definition of Infertility. Dr.

Fertility 101. About SCRC. A Primary Care Approach to Diagnosing and Treating Infertility. Definition of Infertility. Dr. Dr. Shahin Ghadir A Primary Care Approach to Diagnosing and Treating Infertility St. Charles Bend Grand Rounds November 30, 2018 I have no conflicts of interest to disclose. + About SCRC State-of-the-art

More information

Dr Guy Gudex. Director Repromed. 17:00-17:30 Recent Advances in Fertility Management

Dr Guy Gudex. Director Repromed. 17:00-17:30 Recent Advances in Fertility Management Dr Guy Gudex Director Repromed 17:00-17:30 Recent Advances in Fertility Management Recent Advances in Fertility Management Practice Nurses Programme NZMA GP CME June 2018 Dr Guy Gudex ART in NZ -2014 ACART

More information

Is it the seed or the soil? Arthur Leader, MD, FRCSC

Is it the seed or the soil? Arthur Leader, MD, FRCSC The Physiological Limits of Ovarian Stimulation Is it the seed or the soil? Arthur Leader, MD, FRCSC Objectives 1. To consider how ovarian stimulation protocols work in IVF 2. To review the key events

More information

Embryo Selection after IVF

Embryo Selection after IVF Embryo Selection after IVF Embryo Selection after IVF Many of human embryos produced after in vitro fertilization carry abnormal chromosomes. Placing a chromosomally normal embryo (s) into a normal uterus

More information

Luteal phase rescue after GnRHa triggering Progesterone and Estradiol

Luteal phase rescue after GnRHa triggering Progesterone and Estradiol Luteal phase rescue after GnRHa triggering Progesterone and Estradiol L. Engmann University of Connecticut Disclaimer Fertility Speaker Bureau Merck Pharmaceuticals Introduction GnRH agonist is effective

More information

The old IVF patient: An evidence based approach. Stratis Kolibianakis MD MSc PhD

The old IVF patient: An evidence based approach. Stratis Kolibianakis MD MSc PhD The old IVF patient: An evidence based approach Stratis Kolibianakis MD MSc PhD Unit for Human Reproduction 1 st Dept Ob/Gyn Aristotle University of Thessaloniki No conflict of interest How old is old?

More information

A multi-centre, multinational, cross-sectional, incident case control study on Factors associated with the development of

A multi-centre, multinational, cross-sectional, incident case control study on Factors associated with the development of A multi-centre, multinational, cross-sectional, incident case control study on Factors associated with the development of Endometrioma and deep infiltrating endometriosis Professor C. Chapron and the Group

More information

IS PCOS ASSOCIATED WITH A HIGHER PREGNANCY LOSS? NO BY DR SHEELA V.MANE

IS PCOS ASSOCIATED WITH A HIGHER PREGNANCY LOSS? NO BY DR SHEELA V.MANE IS PCOS ASSOCIATED WITH A HIGHER PREGNANCY LOSS? NO BY DR SHEELA V.MANE CURRICULUM VITAE Name Qualifications : Prof. Sheela V. Mane : MBBS, M.D, FICOG, FICMCH Contribution to FOGSI: Chairperson Safe Motherhood

More information

Individualized treatment based on ovarian reserve markers

Individualized treatment based on ovarian reserve markers Individualized treatment based on ovarian reserve markers Prof Dr. Nikolaos P. Polyzos M.D. PhD Professor and Medical Co- Director, Vrije Universiteit Brussel, UZ Brussel, Belgium Professor of Reproduc?ve

More information

lbt lab tests t Conrolled Ovarian Hyperstimulation Dr Soheila Ansaripour

lbt lab tests t Conrolled Ovarian Hyperstimulation Dr Soheila Ansaripour lbt lab tests t and Conrolled Ovarian Hyperstimulation Dr Soheila Ansaripour Research Instituteof Avicenna 4/23/2012 Why good prediction of poor response good prediction i of OHSS application appropriate

More information

Dr Guy Gudex. Gynaecologist and Fertility Specialist Repromed. 9:05-9:30 Advances in Assisted Reproduction What s New?

Dr Guy Gudex. Gynaecologist and Fertility Specialist Repromed. 9:05-9:30 Advances in Assisted Reproduction What s New? Dr Guy Gudex Gynaecologist and Fertility Specialist Repromed 9:05-9:30 Advances in Assisted Reproduction What s New? Rotorua GP CME June 2016 Advances in Assisted Reproduction-What s new? Dr Guy Gudex

More information

Ovarian hyperstimulation syndrome (OHSS)

Ovarian hyperstimulation syndrome (OHSS) Ovarian hyperstimulation syndrome (OHSS) OHSS OHSS: exaggerated response to gonadotropins and hcg Characterized by: ovarian enlargement increased vascular permeability fluid accumulation in abdomen Associated

More information

IVF Health Risk 503,000 Hit in Google in 0.2 seconds

IVF Health Risk 503,000 Hit in Google in 0.2 seconds Assisted Reproductive Technologies and Perinatal Morbidity: Interrogating the Association Kurt Barnhart, M.D., MSCE. William Shippen Jr Professor of Obstetrics and Gynecology and Epidemiology Perelman

More information

IVF Protocols: Hyper & Hypo-Responders, Implantation

IVF Protocols: Hyper & Hypo-Responders, Implantation IVF Protocols: Hyper & Hypo-Responders, Implantation Midwest Reproductive Symposium June 4-5, 4 2010 Subset : Hyper-Responders Mark R. Bush, MD, FACOG, FACS OBJECTIVE: Important goals for the PCOS patient

More information

A new approach to IVF? Soft or mild IVF. Soft or mild IVF

A new approach to IVF? Soft or mild IVF. Soft or mild IVF A new approach to IVF? William Ledger University of Sheffield Centre for Reproductive Medicine and Fertility (w.ledger@sheffield.ac.uk) Soft or mild IVF Less patient discomfort Less complex, shorter stimulation

More information

Single Embryo Transfer

Single Embryo Transfer Single Embryo Transfer Rachel Cutting Principal Embryologist Chair Association of Clinical Embryologists Summary Background to change in UK policy National data Strategies Embryo selection Practical requirements

More information

In Vitro Fertilization in Clomiphene-Resistant Women with Polycystic Ovary Syndrome

In Vitro Fertilization in Clomiphene-Resistant Women with Polycystic Ovary Syndrome Original Article Effect of Laparoscopic Ovarian Drilling on Outcomes of In Vitro Fertilization in Clomiphene-Resistant Women with Polycystic Ovary Syndrome Maryam Eftekhar, M.D. 1, Razieh Deghani Firoozabadi,

More information

Understanding IVF Processes in Surrogacy

Understanding IVF Processes in Surrogacy Melvin H. Thornton II MD Medical Director CT Fertility Understanding IVF Processes in Surrogacy The Basics Surrogacy involves multiple parties IVF CLINIC Egg donors screening and matching* Medical process

More information

Prognosticating ovarian reserve by the new ovarian response prediction index

Prognosticating ovarian reserve by the new ovarian response prediction index International Journal of Reproduction, Contraception, Obstetrics and Gynecology Tak A et al. Int J Reprod Contracept Obstet Gynecol. 2018 Mar;7(3):1196-1200 www.ijrcog.org DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20180917

More information

Optimizing Fertility and Wellness After Cancer. Kat Lin, MD, MSCE

Optimizing Fertility and Wellness After Cancer. Kat Lin, MD, MSCE Optimizing Fertility and Wellness After Cancer Kat Lin, MD, MSCE University Reproductive Care University of Washington Nov. 6, 2010 Optimism in Numbers 5-year survival rate 78% for all childhood cancers

More information

Intérêt de l hcg et induction de l ovulation. Christophe Blockeel, MD, PhD Centre for Reproductive Medicine, Brussels, Belgium

Intérêt de l hcg et induction de l ovulation. Christophe Blockeel, MD, PhD Centre for Reproductive Medicine, Brussels, Belgium Intérêt de l hcg et induction de l ovulation Christophe Blockeel, MD, PhD Centre for Reproductive Medicine, Brussels, Belgium Conflict of interest The opinions expressed in this document are the opinions

More information

Personalizing ovarian stimulation for IVF

Personalizing ovarian stimulation for IVF Personalizing ovarian stimulation for IVF Biljana Popovic-Todorovic MD,PhD Centre for Reproductive Medicine UZ Brussel QuickTime and are needed to see this picture. Controlled ovarian stimulation for IVF/ICSI

More information

Impact of Ovarian Endometrioma Per Se and Surgery on Ovarian Reserve and Pregnancy Rate in in Vitro Fertilization Cycles

Impact of Ovarian Endometrioma Per Se and Surgery on Ovarian Reserve and Pregnancy Rate in in Vitro Fertilization Cycles 1 st SEUD Meeting, 9 May 2015, Paris, France Impact of Ovarian Endometrioma Per Se and Surgery on Ovarian Reserve and Pregnancy Rate in in Vitro Fertilization Cycles ENDOMETRIOSIS ovarian endometrioma

More information

Modified natural cycles: the Italian experience

Modified natural cycles: the Italian experience CLINICA VALLE GIULIA, Rome Modified natural cycles: the Italian experience Filippo Maria Ubaldi M.D. M.Sc. Poor ovarian Response ESHRE Campus symposium Bologna 19-20 March 2010 Introduction Ovarian superovulation

More information

LUTEAL PHASE SUPPORT. Doç. Dr. Nafiye Yılmaz. Zekai Tahir Burak Kadın Sağlığı Eğitim Araştırma Hastanesi

LUTEAL PHASE SUPPORT. Doç. Dr. Nafiye Yılmaz. Zekai Tahir Burak Kadın Sağlığı Eğitim Araştırma Hastanesi LUTEAL PHASE SUPPORT Doç. Dr. Nafiye Yılmaz Zekai Tahir Burak Kadın Sağlığı Eğitim Araştırma Hastanesi TAJEV, 2014 1 ART & success *Live birth rate 2 Optimal luteal phase Etiology of luteal phase deficiency

More information

IVF (,, ) : (HP-hMG) - (IVF- ET) : GnRH, HP-hMG (HP-hMG )57, (rfsh )140, (Gn)

IVF (,, ) : (HP-hMG) - (IVF- ET) : GnRH, HP-hMG (HP-hMG )57, (rfsh )140, (Gn) 34 11 Vol.34 No.11 2014 11 Nov. 2014 Reproduction & Contraception doi: 10.7669/j.issn.0253-3X.2014.11.0892 E-mail: randc_journal@163.com IVF ( 710003) : (H-hMG) - (IVF- ET) : GnRH H-hMG (H-hMG ) (rfsh

More information

Infertility in Women over 35. Alison Jacoby, MD Dept. of Ob/Gyn UCSF

Infertility in Women over 35. Alison Jacoby, MD Dept. of Ob/Gyn UCSF Infertility in Women over 35 Alison Jacoby, MD Dept. of Ob/Gyn UCSF Learning Objectives Review the effect of age on fertility Fertility counseling for the patient >35 - timing - lifestyle - workup Fertility

More information

Dr Manuela Toledo - Procedures in ART -

Dr Manuela Toledo - Procedures in ART - Dr Manuela Toledo - Procedures in ART - Fertility Specialist MBBS FRANZCOG MMed CREI Specialities: IVF & infertility Fertility preservation Consulting Locations East Melbourne Planning a pregnancy - Folic

More information

Use of in vitro maturation for fertility preservation

Use of in vitro maturation for fertility preservation Use of in vitro maturation for fertility preservation G. Arroyo Servei de Medicina de la Reproducció Departament d Obstetrícia, Ginecologia i Reproducció INSTITUT UNIVERSITARI DEXEUS MEDICAL STRATEGY TO

More information

Manish Banker. Declared receipt of grants; member of a company advisory board, board of director or similar group

Manish Banker. Declared receipt of grants; member of a company advisory board, board of director or similar group Manish Banker Nova IVI Fertility Pulse Women's Hospital Gujarat, India Declared receipt of grants; member of a company advisory board, board of director or similar group The Indian point of view Manish

More information

How to make the best use of the natural cycle for frozen-thawed embryo transfer?

How to make the best use of the natural cycle for frozen-thawed embryo transfer? How to make the best use of the natural cycle for frozen-thawed embryo transfer? Ariel Weissman, MD IVF Unit, Dep. Ob/Gyn Wolfson Medical Center, Holon Sackler Faculty of Medicine, Tel Aviv University

More information

Minimal monitoring / Minimal stimulation as a means of increasing access to ART in developing countries

Minimal monitoring / Minimal stimulation as a means of increasing access to ART in developing countries Minimal monitoring / Minimal stimulation as a means of increasing access to ART in developing countries Willem Ombelet Genk Institute for Fertility Technology Maribor, 27-02-09 Third World = overpopulation

More information

JMSCR Vol 06 Issue 09 Page September 2018

JMSCR Vol 06 Issue 09 Page September 2018 www.jmscr.igmpublication.org Impact Factor (SJIF): 6.379 Index Copernicus Value: 79.54 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v6i9.53 Role of Anti-Mullerian Hormone

More information

Laboratoires Genevirer Menotrophin IU 1.8.2

Laboratoires Genevirer Menotrophin IU 1.8.2 Important missing information VI.2 VI.2.1 Elements for a Public Summary Overview of disease epidemiology Infertility is when a woman cannot get pregnant (conceive) despite having regular unprotected sexual

More information

PRETREATMENT ASSESSMENT & MANAGEMENT (MODULE 1 B) March, 2018

PRETREATMENT ASSESSMENT & MANAGEMENT (MODULE 1 B) March, 2018 PRETREATMENT ASSESSMENT & MANAGEMENT (MODULE 1 B) March, 2018 Clinical Assessment A thorough clinical evaluation is a prerequisite for ART A thorough clinical evaluation as detailed in the female and male

More information

INDICATIONS OF IVF/ICSI

INDICATIONS OF IVF/ICSI PROCESS OF IVF/ICSI INDICATIONS OF IVF/ICSI IVF is most clearly indicated when infertility results from one or more causes having no other effective treatment; Tubal disease. In women with blocked fallopian

More information

Natural Cycle & Mild stimulation IVF/ICSI in women with Poor Ovarian Response (POR)

Natural Cycle & Mild stimulation IVF/ICSI in women with Poor Ovarian Response (POR) Natural Cycle & Mild stimulation IVF/ICSI in women with Poor Ovarian Response (POR) Geeta Nargund Head of Reproductive Medicine St George s Hospital London ISMAAR Terminology Human Reprod Nargund et al

More information

Chromosomal Aneuploidy

Chromosomal Aneuploidy The Many Advantages of Trophectoderm Biopsy Compared to Day 3 Biopsy for Pre- Implantation Genetic Screening (PGS) Mandy Katz-Jaffe, PhD Chromosomal Aneuploidy Trisomy 21 Fetus Aneuploidy is the most common

More information

How effective is egg freezing as a preventative treatment for young women in securing their ability to reproduce later in life?

How effective is egg freezing as a preventative treatment for young women in securing their ability to reproduce later in life? How effective is egg freezing as a preventative treatment for young women in securing their ability to reproduce later in life? Vitaly A. Kushnir MD Center for Human Reproduction New York City Milestones

More information

The effect of luteal phase progesterone supplementation on natural frozen-thawed embryo transfer cycles

The effect of luteal phase progesterone supplementation on natural frozen-thawed embryo transfer cycles Original Article Obstet Gynecol Sci 2014;57(4):291-296 http://dx.doi.org/10.5468/ogs.2014.57.4.291 pissn 2287-8572 eissn 2287-8580 The effect of luteal phase progesterone supplementation on natural frozen-thawed

More information

NGUYEN QUOC ANH. M.D., M.Sc. Tu Du Hospital Vietnam

NGUYEN QUOC ANH. M.D., M.Sc. Tu Du Hospital Vietnam NGUYEN QUOC ANH M.D., M.Sc. Tu Du Hospital Vietnam FULLY AUTOMATED AMH TESTING OF OVARIAN RESPONSE IN IVF NGUYỄN QUỐC ANH MD. Infertility dep. Tudu hospital Index What is AMH? Standard AMH testing Fully

More information

Patient selection criteria for blastocyst culture in IVF/ICSI treatment

Patient selection criteria for blastocyst culture in IVF/ICSI treatment J Assist Reprod Genet (2010) 27:555 560 DOI 10.1007/s10815-010-9457-9 ASSISTED REPRODUCTION Patient selection criteria for blastocyst culture in IVF/ICSI treatment M. Y. Thum & V. Wells & H. Abdalla Received:

More information

Effect of ovarian stimulation on oocyte quality and embryonic aneuploidy: a prospective, randomised controlled trial

Effect of ovarian stimulation on oocyte quality and embryonic aneuploidy: a prospective, randomised controlled trial FULL PROJECT TITLE: Effect of ovarian stimulation on oocyte quality and embryonic aneuploidy: a prospective, randomised controlled trial (STimulation Resulting in Embryonic Aneuploidy using Menopur (STREAM)

More information

FERTILITY PRESERVATION. Juergen Eisermann, M.D., F.A.C.O.G South Florida Institute for Reproductive Medicine South Miami Florida

FERTILITY PRESERVATION. Juergen Eisermann, M.D., F.A.C.O.G South Florida Institute for Reproductive Medicine South Miami Florida FERTILITY PRESERVATION Juergen Eisermann, M.D., F.A.C.O.G South Florida Institute for Reproductive Medicine South Miami Florida 1 2 3 4 Oocyte Cryopreservation Experimental option Offer to single cancer

More information

Fertility assessment and assisted conception

Fertility assessment and assisted conception Fertility assessment and assisted conception Dr Geetha Venkat MD FRCOG Director Pulse Learning Women s health 14 September 2016 Disclosure statement Dr Venkat is a director of Harley Street Fertility Clinic.

More information

Infertility Clinical Guideline

Infertility Clinical Guideline Infertility Clinical Guideline Ovarian Stimulation Guideline Purpose: To provide sufficient background regarding various ovarian stimulation protocols for In Vitro Fertilization cycles. Goal: To assist

More information

Anti-Mullerian hormone (AMH) as predictor of ovarian reserve

Anti-Mullerian hormone (AMH) as predictor of ovarian reserve International Journal of Reproduction, Contraception, Obstetrics and Gynecology Shembekar CA et al. Int J Reprod Contracept Obstet Gynecol. 2017 Sep;6(9):4006-4010 www.ijrcog.org DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20174053

More information

Biomarkers for Prediction of Pregnancy Outcome in Fertility Patients. Scott Nelson Muirhead Chair in Obstetrics & Gynaecology

Biomarkers for Prediction of Pregnancy Outcome in Fertility Patients. Scott Nelson Muirhead Chair in Obstetrics & Gynaecology Biomarkers for Prediction of Pregnancy Outcome in Fertility Patients Scott Nelson Muirhead Chair in Obstetrics & Gynaecology Why do we need to know ovarian response? Anna Sarah Just do IVF and see response

More information

Dr. Ernesto Bosch Instituto Valenciano de Infertilidad Valencia, Spain. Declared no potential conflict of interest

Dr. Ernesto Bosch Instituto Valenciano de Infertilidad Valencia, Spain. Declared no potential conflict of interest Dr. Ernesto Bosch Instituto Valenciano de Infertilidad Valencia, Spain Declared no potential conflict of interest Is there a role for LH in elderly patients? Dr. Ernesto Bosch Instituto Valenciano de Infertilidad.

More information

Agonist versus antagonist in ICSI cycles: a randomized trial and cost effectiveness analysis Badrawi A, Zaki S, Al-Inany H, Ramzy A M, Hussein M

Agonist versus antagonist in ICSI cycles: a randomized trial and cost effectiveness analysis Badrawi A, Zaki S, Al-Inany H, Ramzy A M, Hussein M Agonist versus antagonist in ICSI cycles: a randomized trial and cost effectiveness analysis Badrawi A, Zaki S, Al-Inany H, Ramzy A M, Hussein M Record Status This is a critical abstract of an economic

More information

Evaluation of ovarian response prediction according to age and serum AMH levels in IVF cycles: a retrospective analysis

Evaluation of ovarian response prediction according to age and serum AMH levels in IVF cycles: a retrospective analysis International Journal of Reproduction, Contraception, Obstetrics and Gynecology Pillai SM et al. Int J Reprod Contracept Obstet Gynecol. 2017 Aug;6(8):3306-3310 www.ijrcog.org DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20173190

More information

Body mass index and basal androstenedione are independent risk factors for miscarriage in polycystic ovary syndrome

Body mass index and basal androstenedione are independent risk factors for miscarriage in polycystic ovary syndrome Yang et al. Reproductive Biology and Endocrinology (2018) 16:119 https://doi.org/10.1186/s12958-018-0438-7 RESEARCH Open Access Body mass index and basal androstenedione are independent risk factors for

More information

Fertility Policy. December Introduction

Fertility Policy. December Introduction Fertility Policy December 2015 Introduction Camden Clinical Commissioning Group (CCG) is responsible for commissioning a range of health services including hospital, mental health and community services

More information

European IVF Monitoring (EIM) Year: 2013

European IVF Monitoring (EIM) Year: 2013 European IVF Monitoring (EIM) Year: 2013 Name of the country Poland Name and full address of the contact person. Anna Janicka, PhD Polish Society of Reproductive Medicine and Embryology Fertility and Sterility

More information

Understanding eggs, sperm and embryos. Marta Jansa Perez Wolfson Fertility Centre

Understanding eggs, sperm and embryos. Marta Jansa Perez Wolfson Fertility Centre Understanding eggs, sperm and embryos Marta Jansa Perez Wolfson Fertility Centre What does embryology involve? Aims of the embryology laboratory Creation of a large number of embryos and supporting their

More information

Myths About Success Rates Do they truly reflect quality of care

Myths About Success Rates Do they truly reflect quality of care Myths About Success Rates Do they truly reflect quality of care Barry Behr PhD., HCLD Professor and IVF Laboratory Director Division of Reproductive Endocrinology and Infertility Dept OB/GYN Stanford University

More information

COMPARING AMH, AFC AND FSH FOR PREDICTING HIGH OVARIAN RESPONSE IN WOMEN UNDERGOING ANTAGONIST PROTOCOL

COMPARING AMH, AFC AND FSH FOR PREDICTING HIGH OVARIAN RESPONSE IN WOMEN UNDERGOING ANTAGONIST PROTOCOL COMPARING AMH, AFC AND FSH FOR PREDICTING HIGH OVARIAN RESPONSE IN WOMEN UNDERGOING ANTAGONIST PROTOCOL Nguyen Xuan Hoi1, Nguyen Manh Ha2 1 National Obstetrics and Gynecology Hospital, 2Hanoi Medical Unviversity

More information

Prognostic factors of ovarian response and IVF outcome in patients with deep infiltrating endometriosis Claire GAUCHE-CAZALIS, Chadi YAZBECK

Prognostic factors of ovarian response and IVF outcome in patients with deep infiltrating endometriosis Claire GAUCHE-CAZALIS, Chadi YAZBECK Prognostic factors of ovarian response and IVF outcome in patients with deep infiltrating endometriosis Claire GAUCHE-CAZALIS, Chadi YAZBECK Obstetrics Gynecology and Reproductive Medicine Department Bichat

More information

LOW RESPONDERS. Poor Ovarian Response, Por

LOW RESPONDERS. Poor Ovarian Response, Por LOW RESPONDERS Poor Ovarian Response, Por Patients with a low number of retrieved oocytes despite adequate ovarian stimulation during fertility treatment. Diagnosis Female About Low responders In patients

More information

How to make the best use of the natural cycle for frozen-thawed embryo transfer?

How to make the best use of the natural cycle for frozen-thawed embryo transfer? How to make the best use of the natural cycle for frozen-thawed embryo transfer? Ariel Weissman, MD IVF Unit, Dep. Ob/Gyn Wolfson Medical Center, Holon Sackler Faculty of Medicine, Tel Aviv University

More information

Fertility Preservation for Breast Cancer. Elizabeth S. Ginsburg MD Medical Director, ART Program Brigham & Women s Hospital

Fertility Preservation for Breast Cancer. Elizabeth S. Ginsburg MD Medical Director, ART Program Brigham & Women s Hospital Fertility Preservation for Breast Cancer Elizabeth S. Ginsburg MD Medical Director, ART Program Brigham & Women s Hospital Learning Objectives To be able to list and describe processes of ovulation induction

More information

The Jones Institute for Reproductive Medicine Founded on Science, Dedicated to Life

The Jones Institute for Reproductive Medicine Founded on Science, Dedicated to Life The Jones Institute for Reproductive Medicine Founded on Science, Dedicated to Life Assisted reproductive technologies: State-of-the-ART Sergio Oehninger, MD, PhD Professor and Vice-Chair, Dept. Ob/Gyn

More information

Endometrial Preparation for Frozen Embryo Transfer (FET) Zitao Liu, MD, PhD New Hope Fertility Center, NY

Endometrial Preparation for Frozen Embryo Transfer (FET) Zitao Liu, MD, PhD New Hope Fertility Center, NY Endometrial Preparation for Frozen Embryo Transfer (FET) Zitao Liu, MD, PhD New Hope Fertility Center, NY Natural Cycle FET Protocol for endometrial preparation N FET, including modified N FET HRT FET:

More information

The emergence of Personalized Medicine protocols for IVF.

The emergence of Personalized Medicine protocols for IVF. Individualising IVF: Introduction to the POSEIDON Concept Introduction The emergence of Personalized Medicine protocols for IVF. Differences between patients: age, ovarian reserve, BMI or presence of ovarian

More information

Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche. Tecniche di sincronizzazione ovocitaria. La sincronizzazione follicolare

Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche. Tecniche di sincronizzazione ovocitaria. La sincronizzazione follicolare Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche Tecniche di sincronizzazione ovocitaria. La sincronizzazione follicolare Carlo Alviggi The rational of Follicular synchronization

More information

A mild strategy in IVF results in favourable outcomes in terms of term live birth, cost and patient discomfort

A mild strategy in IVF results in favourable outcomes in terms of term live birth, cost and patient discomfort Chapter 6 A mild strategy in IVF results in favourable outcomes in terms of term live birth, cost and patient discomfort Heijnen E.M., Eijkemans M.J., De Klerk C., Polinder S., Beckers N.G., Klinkert E.R.,

More information

Polycystic Ovary Disease: A Common Endocrine Disorder in Women

Polycystic Ovary Disease: A Common Endocrine Disorder in Women Polycystic Ovary Disease: A Common Endocrine Disorder in Women Paul Kaplan, M.D. Clinical Professor of Reproductive Endocrinology - OHSU Courtesy Senior Research Associate, Human Physiology University

More information

Hana Park, Chung-Hoon Kim, Eun-Young Kim, Jei-Won Moon, Sung-Hoon Kim, Hee-Dong Chae, Byung-Moon Kang

Hana Park, Chung-Hoon Kim, Eun-Young Kim, Jei-Won Moon, Sung-Hoon Kim, Hee-Dong Chae, Byung-Moon Kang Original Article Obstet Gynecol Sci 2015;58(6):481-486 http://dx.doi.org/10.5468/ogs.2015.58.6.481 pissn 2287-8572 eissn 2287-8580 Effect of second-line surgery on in vitro fertilization outcome in infertile

More information

Infertility treatment

Infertility treatment In the name of God Infertility treatment Treatment options The optimal treatment is one that provide an acceptable success rate, has minimal risk and is costeffective. The treatment options are: 1- Ovulation

More information

How to advise the couple planning to conceive: Modifiable factors that may (or may not) impact fertility

How to advise the couple planning to conceive: Modifiable factors that may (or may not) impact fertility How to advise the couple planning to conceive: Modifiable factors that may (or may not) impact fertility I have nothing to disclose Disclosures Heather Huddleston, MD Associate Professor of Clinical Medicine

More information

A prospective randomised study comparing a GnRH-antagonist versus a GnRH-agonist short protocol for ovarian stimulation in patients referred for IVF

A prospective randomised study comparing a GnRH-antagonist versus a GnRH-agonist short protocol for ovarian stimulation in patients referred for IVF FVV IN OBGYN, 2012, 4 (2): 82-87 Original paper A prospective randomised study comparing a GnRH-antagonist versus a GnRH-agonist short protocol for ovarian stimulation in patients referred for IVF S. GORDTS,

More information

Menstruation-free interval and ongoing pregnancy in IVF using GnRH antagonists

Menstruation-free interval and ongoing pregnancy in IVF using GnRH antagonists Human Reproduction Vol.21, No.4 pp. 1012 1017, 2006 Advance Access publication December 8, 2005. doi:10.1093/humrep/dei415 Menstruation-free interval and ongoing pregnancy in IVF using GnRH antagonists

More information

Saudi Journal of Medicine (SJM)

Saudi Journal of Medicine (SJM) Saudi Journal of Medicine (SJM) Scholars Middle East Publishers Dubai, United Arab Emirates Website: http://scholarsmepub.com/ ISSN 2518-3389 (Print) ISSN 2518-3397 (Online) Factors Affecting Outcomes

More information

The serum estradiol/oocyte ratio in patients with breast cancer undergoing ovarian stimulation with letrozole and gonadotropins

The serum estradiol/oocyte ratio in patients with breast cancer undergoing ovarian stimulation with letrozole and gonadotropins Original Article Obstet Gynecol Sci 2018;61(2):242-246 https://doi.org/10.5468/ogs.2018.61.2.242 pissn 2287-8572 eissn 2287-8580 The serum estradiol/oocyte ratio in patients with breast cancer undergoing

More information

Approved January Waltham Forest CCG Fertility policy

Approved January Waltham Forest CCG Fertility policy Approved January 2015 Waltham Forest CCG Fertility policy Contents 1 Introduction 1 2 Individual Funding Requests 1 2.1 Eligibility criteria 1 2.2 Number of cycles funded 2 2.3 Treatment Pathway 3 Page

More information

IN VITRO MATURATION OF HUMAN OOCYTES

IN VITRO MATURATION OF HUMAN OOCYTES REVIEW ARTICLE IN VITRO MATURATION OF HUMAN OOCYTES Yu-Hung Lin 1,2, Jiann-Loung Hwang 1,3 * 1 Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, 2 School of Medicine, Fu Jen

More information